He had also ruled out a brain injury caused at birth because the injuries were recent.

Accidental injury had also been ruled out because nothing in the baby’s clinical history suggested such injury.

“The most likely explanation is non-accidental injury and the most likely mechanism is shaking.”

He said most experts believed shaking a baby could cause the sort of injuries Alfie had suffered, although not all experts agreed.

“We do not see this pattern of bruising in brain injury as a result of normal handling, what we might call rough and tumble,” he said.

“In my view it is likely that the degree of force required to produce this sort of injury, an independent witness would see it as an inappropriate way to handle a child which would be harmful to the child.

“In my view there would have been a major change in his behaviour and he would not have behaved in any way normally afterwards.”